Understanding C-Section Scars

by: Robert Kessler, MD - Plastic Surgeon, Newport Beach CA

A well placed Cesarean section scar is placed across the top of the pubic hairline. How this scar heals relies not only on the individuals healing but on the closure technique used by your obstetrician. As a plastic surgeon, I see many c section scars which are wide, depressed and even stuck to the underlying tissue creating a fold in the contour of the lower abdomen.

The good news is that most of these issues can be corrected with scar revision or tummy tuck accompanied by post-operative compression garments.

With a tummy tuck the c-section scar is completely removed and the underlying strength layer of the abdomen called the Scarpa’s fascia is approximated with suture. The tension of the closure is placed on this layer so minimal tension is placed on the skin. Tension is one of the main causes of wide scarring. The second benefit of putting Scarpa’s fascia together is that it prevents a depression or a tethered scar when all is healed.

Post-operative compression garments have been shown to decrease the incidence of fluid collections occurring at the surgical site. They also minimize swelling which can lead to tension across the incisions. Tissue fluid can accumulate in the tissue as well as in the spaces created by the surgical procedure. Both processes have a negative impact on healing. Most individuals also experience decreased post-operative pain while wearing compressive garments. These garment can also be used to hold silicone sheeting in place which has clearly been shown to diminish the occurrence of hypertrophic or keloid scarring. Abdominoplasty and liposuction patients clearly achieve their final aesthetic results much sooner with compressive garments than individuals who elect not to wear them.